Causes of death in HIV-infected patients from the Cologne-Bonn cohort
Causes of death in HIV-infected patients from the Cologne-Bonn cohort
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DOI：
10.1007/s15010-013-0535-7
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发表时间：
2014-02-01
期刊：
影响因子：
7.5
通讯作者：
Faetkenheuer, G.
中科院分区：
文献类型：
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作者：
Ehren, K.;Hertenstein, C.;Faetkenheuer, G.
在过去几年中，在资源丰富的国家，人类免疫缺陷病毒（HIV）感染者的死亡原因发生了变化。与后天免疫机能丧失综合症（艾滋病）有关的疾病已不那么普遍，而非艾滋病原因造成的死亡却在增加。本研究的目的是分析脑炎ne-Bonn队列的死亡原因。使用CoDe算法（HIV项目死亡原因编码）系统记录了2004年至2010年期间脑炎ne-Bonn队列的死亡原因。在2004年至2010年随访的3，165例患者中，发生了182例死亡（5.7%，153例男性，29例女性）。死亡时的中位年龄为47岁（范围24-85岁）。最常见的死亡原因是艾滋病定义事件（n = 60，33%），非霍奇金淋巴瘤（NHL）（n = 29，16%）和感染（n = 20，11%）是这一类别中的主要疾病。非艾滋病恶性肿瘤占16%（n = 29），非HIV相关感染占10%（n = 18），心血管疾病占7%（n = 14），自杀或意外占4%（n = 7），肝脏疾病占3%（n = 5）（未知n = 47，26%）。虽然大多数患者（92.5%）接受抗逆转录病毒治疗（ART），但只有50%的患者在死亡前最后一次就诊时病毒学抑制（HIV-RNA < 50拷贝/mL），44%的患者CD 4+计数降低（< 200/μ L）。由于这些死亡大多数是在严重免疫抑制的情况下发生的，因此可以通过早期诊断和治疗艾滋病毒感染来预防。护理提供者必须意识到艾滋病毒感染者患各种疾病的风险增加，并应采取适当的预防措施。
Causes of death in human immunodeficiency virus (HIV)-infected subjects have changed in countries with high resources over the last several years. Acquired immunodeficiency syndrome (AIDS)-related diseases have become less prevalent, whereas deaths due to non-AIDS causes are increasing. The aim of the present study was to analyse causes of death in the Cologne-Bonn cohort.Causes of death from the Cologne-Bonn cohort between 2004 and 2010 were systematically recorded using the CoDe algorithm (The Coding Causes of Death in HIV Project).In 3,165 patients followed from 2004 to 2010, 182 deaths occurred (5.7 %, 153 males, 29 females). The median age at the time of death was 47 years (range 24-85 years). The most frequent causes of death were AIDS-defining events (n = 60, 33 %), with non-Hodgkin lymphoma (NHL) (n = 29, 16 %) and infections (n = 20, 11 %) being the leading entities in this category. Non-AIDS malignancies accounted for 16 % (n = 29), non-HIV-related infections for 10 % (n = 18), cardiovascular diseases for 7 % (n = 14), suicide or accident for 4 % (n = 7) and liver diseases for 3 % (n = 5) of deaths (unknown n = 47, 26 %). Although the majority of patients (92.5 %) was on antiretroviral therapy (ART), only 50 % were virologically suppressed (HIV-RNA < 50 copies/mL) and 44 % had a decreased CD4+ count (< 200/mu L) at their last visit before death.One-third of the causes of death in our cohort between 2004 and 2010 was AIDS-related. Since most of these deaths occur with severe immune suppression, they can possibly be prevented by the early diagnosis and treatment of HIV infection. Care providers must be aware of an increased risk for a broad range of diseases in HIV-infected patients and should apply appropriate preventive measures.